-
F1000Research 2021This research was developed to study the epidemiology of anisometropia. It aims to estimate the prevalence of anisometropia in Portuguese children and adolescents at... (Observational Study)
Observational Study
This research was developed to study the epidemiology of anisometropia. It aims to estimate the prevalence of anisometropia in Portuguese children and adolescents at various educational stages, studying its association with sociodemographic variables. Observational cross sectional study envolving 749 children and adolescents (from 3 to 16 years old) from the central region of Portugal. The refraction was performed with a paediatric, open field auto refractometer (PlusOptix), without cycloplegia and under binocular conditions, to determine the rate of anisometropia and its association with gender, study cycle and area of residence. The prevalence of anisometropia in the studied sample was 6.1%, varying from 2.9% in pre-school education to 9.4% in the 3rd study cycle. Myopic anisometropia was the most prevalent and hyperopic and astigmatic anisometropia showed identical proportions of occurrence. No statistical differences were found between genders or between areas of residence regarding the rate of anisometropia. Regarding spherical equivalent anisometropia, there was a pattern of variation that increased with the cycle of studies (p = 0.012), with myopic anisometropia being the main contributor to this variation. This study found an increase in anisometropia with the educational stage. The high rate of anisometropia found in adolescents (9.4%) as well as the progressive increase in this rate throughout school progress (from 2.9% to 9.4%) suggests the need to extend the detection strategies of this condition beyond childhood.
Topics: Adolescent; Anisometropia; Child; Child, Preschool; Cross-Sectional Studies; Female; Humans; Male; Myopia; Prevalence; Refraction, Ocular
PubMed: 35035896
DOI: 10.12688/f1000research.73657.4 -
Scientific Reports Aug 2023Anisometropia is a unique condition of both eyes and it is associated with vision problems such as amblyopia and reduced stereoacuity. Previous studies have not reported...
Anisometropia is a unique condition of both eyes and it is associated with vision problems such as amblyopia and reduced stereoacuity. Previous studies have not reported its change pattern by age and its correlation with the refractive condition of both eyes. This study aims to compare the changes in anisometropia by age in children with hyperopia, myopia, and antimetropia. In total, 156 children were included. Children aged 3-11 years with anisometropia ≥ 1.00 D were followed up for ≥ 1 year with ≥ 2 visits at two medical centers in Taiwan. Refractive errors by cycloplegic autorefractometry, best-corrected visual acuity, eye position, and atropine use were recorded. The children were divided into hyperopic, myopic, and antimetropic groups. The results showed that anisometropia decreased in children aged < 6 years (3.34-2.96 D; P = 0.038) and increased in older children (2.16-2.55 D; P = 0.005). In children aged 3, 4, 5, and 6 years, the mean anisometropia was higher in children with myopia and antimetropia than in those with hyperopia (P = 0.005, 0.002, 0.001, and 0.011, respectively). The differences were not significant in children aged > 6 years (all P > 0.05). The factors associated with changes in anisometropia were age, refractive group, amblyopia, and strabismus. Anisometropia decreased with age in children younger than 6 years, and the changes in anisometropia was found in children with myopia and antimetropia.
Topics: Child; Humans; Anisometropia; Hyperopia; Amblyopia; Myopia; Eye; Refractive Errors
PubMed: 37608064
DOI: 10.1038/s41598-023-40831-0 -
Vision Research May 2017We investigated the potential causal relationships between anisometropia, amblyopia and strabismus, specifically to determine whether either amblyopia or strabismus... (Review)
Review
We investigated the potential causal relationships between anisometropia, amblyopia and strabismus, specifically to determine whether either amblyopia or strabismus interfered with emmetropization. We analyzed data from non-human primates that were relevant to the co-existence of anisometropia, amblyopia and strabismus in children. We relied on interocular comparisons of spatial vision and refractive development in animals reared with 1) monocular form deprivation; 2) anisometropia optically imposed by either contact lenses or spectacle lenses; 3) organic amblyopia produced by laser ablation of the fovea; and 4) strabismus that was either optically imposed with prisms or produced by either surgical or pharmacological manipulation of the extraocular muscles. Hyperopic anisometropia imposed early in life produced amblyopia in a dose-dependent manner. However, when potential methodological confounds were taken into account, there was no support for the hypothesis that the presence of amblyopia interferes with emmetropization or promotes hyperopia or that the degree of image degradation determines the direction of eye growth. To the contrary, there was strong evidence that amblyopic eyes were able to detect the presence of a refractive error and alter ocular growth to eliminate the ametropia. On the other hand, early onset strabismus, both optically and surgically imposed, disrupted the emmetropization process producing anisometropia. In surgical strabismus, the deviating eyes were typically more hyperopic than their fellow fixating eyes. The results show that early hyperopic anisometropia is a significant risk factor for amblyopia. Early esotropia can trigger the onset of both anisometropia and amblyopia. However, amblyopia, in isolation, does not pose a significant risk for the development of hyperopia or anisometropia.
Topics: Amblyopia; Animals; Anisometropia; Disease Models, Animal; Macaca; Strabismus; Visual Acuity
PubMed: 28404522
DOI: 10.1016/j.visres.2017.03.004 -
GMS Ophthalmology Cases 2020To report two cases of vitreous cysts with discussion of their pathophysiology and management. Clinical examination with fundus photography, ultrasound and optical...
To report two cases of vitreous cysts with discussion of their pathophysiology and management. Clinical examination with fundus photography, ultrasound and optical coherence tomography. Histopathology was performed in the first case. The first case illustrates a pigmented, free-floating cyst, which was removed during a 27-gauge vitrectomy. The histopathology shows a single layer of pigmented epithelium and confirms the previously reported presence of a PAS-positive basement membrane. The second case shows a sessile, non-pigmented cyst associated with significant anisometropia. Primary vitreous cysts are rare and can have a wide range in their clinical aspect. This likely reflects whether they originate either from the pigment epithelium or the primary hyaloidal system. The management of vitreous cysts is mostly conservative, but pars plana vitrectomy can be used safely if the symptoms are debilitating.
PubMed: 32676263
DOI: 10.3205/oc000145 -
Journal of Binocular Vision and Ocular... 2019Anisometropic amblyopia is unilateral by definition and current treatment recommendations reflect that characteristic. However, recent research suggests a binocular... (Review)
Review
Anisometropic amblyopia is unilateral by definition and current treatment recommendations reflect that characteristic. However, recent research suggests a binocular component that deserves consideration. The aim of this review is to consider the levels of anisometropia deemed amblyogenic, and the cortical changes that occur in the presence of anisometropic amblyopia. Particular attention is given to cortical changes that impact the binocularity of these individuals. Knowledge of binocular deficits in anisometropic amblyopia has implications for current, accepted treatment regimens which are monocular in nature. Therefore, the integrity of binocular function in anisometropic amblyopia and its impact on the visual outcome will be evaluated. Given the rise in binocular treatments under clinical trial for amblyopia, this review also aims to evaluate the evidence of potentially enhanced benefits to anisometropic amblyopes from proposed new binocular therapies.
Topics: Amblyopia; Contrast Sensitivity; Humans; Vision, Binocular; Visual Acuity; Visual Cortex
PubMed: 31486743
DOI: 10.1080/2576117X.2019.1656034 -
The British and Irish Orthoptic Journal 2020Clinically, aniseikonia (a perceived difference in shape and image size between the eyes) is often neglected in anisometropic amblyopia due to assumed measurement...
PURPOSE
Clinically, aniseikonia (a perceived difference in shape and image size between the eyes) is often neglected in anisometropic amblyopia due to assumed measurement difficulties. Therefore, we currently lack evidence on whether correction of aniseikonia is beneficial. This study aimed to determine whether subjective aniseikonia is measurable in anisometropia with or without amblyopia.
METHODS
Participants (15-52 years) with Anisometropic Amblyopia (n = 7), Anisometropia without amblyopia (n = 6) and Isometropic Controls (n = 6) were recruited. Subjective aniseikonia was measured using three clinical techniques: Robertson Technique (RT) (penlight and Maddox rod), Aniseikonia Inspector Version 3 (AI3), and the New Aniseikonia Test booklet (NAT), and a psychophysical adaptive method, the Contrast-balanced Aniseikonia Test (CAT), where dichoptic contrast adjustments compensate for any suppression.
RESULTS
Eighteen participants completed all tests, one Anisometropic Amblyopia participant could only complete the CAT and NAT due to fusion loss. The Anisometropic Amblyopia group exhibited the most aniseikonia (range -1.50-+10.50%) followed by Anisometropic Controls (range -3.30-+4.50%) and Isometropic Controls (range -1.50-+3.28%). There was a significant trend of more subjective aniseikonia with increasing amounts of anisometropia across all four tests (AI3 r = 0.630, p = 0.005; NAT r = 0.542, p = 0.017; RT r = 0.499, p = 0.035; CAT r = 0.440, p = 0.059. Bland Altman analysis demonstrated clinically significant levels of variability between the tests.
CONCLUSIONS
Subjective aniseikonia can be reliably measured in patients with anisometropia and suppression. Subjective aniseikonia measurement is recommended as four of the most commonly used clinical tests did not support the 1% per dioptre rule of thumb.
PubMed: 34278210
DOI: 10.22599/bioj.154 -
Journal of Ophthalmology 2017To study the effect of surgery on amblyopia and suppression associated with congenital cyclovertical strabismus.
PURPOSE
To study the effect of surgery on amblyopia and suppression associated with congenital cyclovertical strabismus.
METHODS
The fixation pattern was investigated with microperimetry before and soon after surgery in ten consecutive children operated for congenital superior oblique palsy at the S. Martino Hospital, Belluno, Italy, between September 2014 and December 2015. Changes in visual performance in terms of best-corrected visual acuity (BCVA) and stereopsis between the day before and one week after surgery were also evaluated. No other amblyopia treatment has been administered during the time study.
RESULTS
Surgical correction of the excyclodeviation in congenital SO palsy determined monocular and binocular sensory consequences: monocularly, in the cyclodeviated amblyopic eye, BCVA (0.46-0.03 LogMAR; < 0.0001) and the fixation pattern improved, as demonstrated by microperimetry examination. Binocularly, stereopsis improved or emerged while suppression at the Worth four-dot test disappeared.
CONCLUSIONS
In the absence of further amblyopic factors such as coexisting constant vertical and/or horizontal deviation and anisometropia, the amblyopia encountered in congenital SO palsy may resolve soon after the surgical alignment. Therefore, it may be considered and defined "pseudoamblyopia."
PubMed: 28831303
DOI: 10.1155/2017/1870290 -
Indian Journal of Ophthalmology Feb 2022To assess the level of stereopsis in school children with spectacle-corrected refractive errors using Titmus fly and Randot stereo tests, evaluate the factors associated...
PURPOSE
To assess the level of stereopsis in school children with spectacle-corrected refractive errors using Titmus fly and Randot stereo tests, evaluate the factors associated with the level of stereopsis, and determine the level of agreement between the two tests.
METHODS
A cross-sectional study was done on 5- to 18-year-old school-children wearing spectacles for at least 1-month duration. Visual acuity was assessed using Snellen's visual acuity chart, and their spectacle correction being used currently was measured using an auto lensmeter. The level of stereopsis was assessed using Randot and Titmus fly stereo tests. Data were entered using Microsoft Excel and analyzed using IBM-SPSS version 20, Chicago, IL. The associations between stereopsis and type of refractive error, visual acuity, age, and gender were analyzed. An agreement between Randot and Titmus fly test was done using Kappa statistics.
RESULTS
A total of 222 children (101 boys and 121 girls; mean age 13 years) were assessed. Astigmatism was the most prevalent refractive error (60.4%), followed by myopia (24.8%) and hypermetropia (1.4%). Thirty children (13.5%) had anisometropia. All hyperopes had normal stereopsis. Children with spherical myopia had better stereopsis, followed by astigmatism and anisometropia in the same order (P = 0.036). Children with anisometropia ≤1.5 D had better stereopsis than anisometropia more than 1.5 D. Stereopsis was also found to have no correlation with the age and visual acuity at the time of testing or the age at which the child first started wearing spectacles. Stereopsis values obtained from Randot and Titmus fly stereo tests showed moderate agreement with Kappa value 0.581.
CONCLUSION
Anisometropia and astigmatism are the most critical factors determining the level of stereopsis in refractive errors.
Topics: Adolescent; Anisometropia; Child; Cross-Sectional Studies; Depth Perception; Eyeglasses; Humans; Refractive Errors
PubMed: 35086245
DOI: 10.4103/ijo.IJO_997_21 -
Frontiers in Public Health 2022To investigate anisometropia's prevalence and associated factors in school-aged children.
OBJECTIVE
To investigate anisometropia's prevalence and associated factors in school-aged children.
METHODS
A cross-sectional school-based study was conducted in Shandong Province, China, including children aged 4 to 17 from 9 schools. Anisometropia was defined as the differences between the two eyes in spherical equivalent (SE) or cylinder degree of 1.00 diopter (D) or more [SE or cylindrical (CYL) difference ≥ 1.00 D] after cycloplegic autorefraction. The Generalized Linear Model (GLM) was used to analyze the effects of ocular parameters [the differences between eyes in axial length (AL), habitual visual acuity (HVA), and corneal astigmatism (CA)] and lifestyle parameters (time spent indoor near work and outdoor activities) on anisometropia.
RESULTS
Total 4,198 (93.4%) of the 4,494 children were included in the statistical analysis. The mean difference in inter-eye SE was 0.42 ± 0.61 D. The prevalence of anisometropia was 13.2% (95%CI: 12.1 to 14.2%) (SE anisometropia's prevalence:10.3%; CYL anisometropia's prevalence: 4.1%), increased with older age (OR = 1.10, = 0.002), the worse myopic eye (myopia vs. premyopia, OR = 1.87, = 0.002), the worse hyperopic eye (hyperopia vs. premyopia, OR = 1.77, = 0.013), larger difference in inter-eye AL (0.1-0.3 vs. ≤ 0.1, OR = 1.67, = 0.008; >0.3 vs. ≤ 0.1, OR = 28.61, < 0.001), HVA (>0.2 vs. ≤ 0.2, OR = 3.01, < 0.001), CA (OR = 6.24, < 0.001), the worse stereoacuity (>100 vs. ≤ 100, OR = 1.59, = 0.001), longer indoor near work time per day on weekends (4-8 vs. <4, OR = 1.41, = 0.038; ≥8 vs. <4, OR = 1.40, = 0.131), and shorter outdoor activity time per day on weekdays (≥1 vs. <1, OR = 0.75, = 0.046) in multivariable analysis. In the SE anisometropia group, the difference in inter-eye AL (>0.3 vs. ≤ 0.1, β: 0.556, 95%CI: 0.050 to 1.063), HVA (>0.2 vs. ≤ 0.2, β: 0.511, 95%CI: 0.312 to 0.710), and CA (β: 0.488, 95%CI: 0.289 to 0.688), stereoacuity (>100 vs. ≤ 100, β: 0.299, 95%CI: 0.110 to 0.488) had a positive impact on the difference in inter-eye SE.
CONCLUSIONS
Ocular parameters and lifestyle parameters are associated with the occurrence of anisometropia in children aged 4 to 17 years, including the difference in inter-eye AL, HVA, CA, stereoacuity, indoor near work time, and outdoor activity time. Preventing myopia and early treating anisometropic amblyopia may be effective ways to reduce the prevalence of anisometropia.
Topics: Humans; Child; Anisometropia; Prevalence; Cross-Sectional Studies; Amblyopia; Astigmatism; Myopia
PubMed: 36620276
DOI: 10.3389/fpubh.2022.1072574 -
Cureus Sep 2022The aim of this article is to report two cases of Straatsma syndrome, a rare disease characterized by the traditional triad of unilateral myelinated retinal nerve...
The aim of this article is to report two cases of Straatsma syndrome, a rare disease characterized by the traditional triad of unilateral myelinated retinal nerve fibres, axial myopia, and amblyopia. The cases were a five-year-old and a three-year-old girl, both with unilateral myopia, visual acuity of 0.1 (decimal), and myelinated retinal nerve fibres in fundoscopy. Prescription of cycloplegic refraction findings and occlusion of the involved eye was attempted in both cases, but visual acuity did not improve. Poor-prognostic factors of Straatsma syndrome include a high degree of anisometropia and extensive myelination.
PubMed: 36340550
DOI: 10.7759/cureus.29779